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Falciform ligament appendagitis is an extremely rare form of intra-abdominal focal fat infarction. It usually presents with vigorous abdominal pain and mimics other more common acute abdominal pain-associated diseases. Better recognition of this entity avoids misdiagnoses and unnecessary surgical treatment. We present the case of a 73-year-old woman admitted to the emergency department for abdominal pain, nausea, and vomiting. She had a fever and a diffuse tender abdomen with upper right quadrant pain. Laboratory investigation showed leukocytosis and high C-reactive protein. CT revealed a heterogeneous increased density of fat adjacent to the falciform ligament. Falciform ligament appendagitis was diagnosed and antibiotic and anti-inflammatory treatment resulted in complete recovery. This case highlights the need to raise awareness and better recognize falciform ligament appendagitis to avoid unnecessary surgical interventions.

Portuguese ceramic tile (azulejo) production has evolved significantly since its beginnings in the 16th century. While historic tiles reflect well-established traditional techniques and styles, modern and contemporary works began to explore new aesthetic and material possibilities, introducing textures, surface effects, and experimental approaches that challenge conventional conservation methods. This study examines a contemporary Portuguese tile panel dated from 1987, featuring decorative effect glazes with crater and crazing textures, which were characterized and reproduced. Analytical techniques, including optical microscopy, micro-X-ray fluorescence spectrometry, and Raman spectroscopy in microscopic mode, were employed to characterize material composition and formation mechanisms. Results showed that the crater-effect glazes were achieved with a silica-rich glaze recipe with MnO2 and ZrO2. The crazing effect developed in regions where unmelted crystalline silica induced internal stresses within a lead-silicate glaze, contributing to localized degradation. Experimental reproductions of the glazes, guided by analytical data, were conducted to better understand their formation and inform conservation strategies. The results provide essential insights for the technical assessment, documentation, and preservation of contemporary ceramic artworks featuring decorative effect glazes and contribute to the broader field of cultural heritage conservation.

Vulvar leiomyomas are extremely rare smooth muscle tumors that are easily mistaken for other lesions, as the differential diagnosis must consider a wide spectrum of benign and malignant lesions. We present the case of a 52-year-old woman with a three-year history of progressive abdominal distension and pain and an enlarging vulvar mass distorting the labia majora and causing gait disturbance. Imaging confirmed an enormous pelvic mass originating in the uterus, compatible with a leiomyoma/sarcoma, and large perineal and vulvar masses with similar characteristics. Histopathology after surgical removal revealed benign abdominal, vulvar, and perineal leiomyomas. This case highlights the rarity and diagnostic challenges of extra-uterine leiomyomas, particularly those in the vulvar region.

A modular X-ray scanning system was developed, to fill in the gap between portable instruments (with a limited analytical area) and mobile instruments (with large analytical areas, and sometimes bulky and difficult to transport). The scanner has been compared to a commercial tabletop instrument, by analysing a Portuguese tile (azulejo) from the 17th century. Complementary techniques were used to achieve a throughout characterisation of the sample in a complete non-destructive approach. The complexity of the acquired X-ray fluorescence (XRF) spectra, due to inherent sample stratigraphy, has been resolved using Monte Carlo simulations, and Raman spectroscopy, as the most suitable technique to complement the analysis of azulejos colours, yielding satisfactory results. The colouring agents were identified as cobalt blue and a Zn-modified Naples-yellow. The stratigraphy of the area under study was partially modelled with Monte Carlo simulations. The scanners performance has been compared by evaluating the images outputs and the global spectrum.

This study offers fresh insights into the technical and stylistic exchanges between Flemish and Portuguese panel painting during the late 15th and early 16th centuries. By comparing two contemporaneous works, we trace Flemish influence in Portugal through a detailed materials and techniques analysis. Non-invasive, in situ methods—including energy dispersive X-ray fluorescence (XRF), macro-photography (MP), infrared reflectography (IRR), and dendrochronology—were used to examine each painting’s wooden support, ground layer, underdrawing, and pigment stratigraphy. Select micro-sampling analyses—micro-Fourier-transform infrared spectroscopy (μ-FTIR), scanning electron microscopy with energy dispersive spectroscopy (SEM-EDS), and micro-Raman spectroscopy (µ-Raman)—provided complementary data on binder and pigment composition. While both paintings share nearly identical pigments and layering sequences and employ comparable coating techniques, their ground compositions differ subtly. Notably, the Flemish work features extensive gold-leaf application, whereas underdrawing execution takes on principal importance in the Portuguese example. Together, these findings reveal that Jorge Afonso’s workshop developed a distinct Portuguese method—rooted in Flemish practices disseminated by Quentin Metsys—yet adapted to local materials and aesthetic priorities.

Monoclonal gammopathies (MGs) are a wide range of diseases that may evolve or progress over time. Comorbidity plays a critical role in this setting. The co-occurrence of two MGs is not a rare event. The evidence on the association of systemic light chain (AL) amyloidosis and multiple myeloma (MM) is scarce and controversial. Herein we aim to address this topic in a large series of patients of a referral center. All consecutive AL amyloidosis patients treated at our center from January 2005 to April 2023 were prospectively enrolled in a clinical and epidemiological registry. 141 patients diagnosed with AL amyloidosis were included, of which 7 (5%) had localized whereas 134 presented with systemic disease. The heart was the most frequently affected organ (90.3%). 25 patients (18.7%) fulfilled the IMWG diagnostic criteria of MM (AL/MM). Time-dependent association between AL and MM showed that the synchronous pattern is more frequent than the appearance of a second primary malignancy. The diagnostic delay was six months (m). Patients with AL/MM had a poorer median overall survival (OS) than AL-only patients (35.5 m, CI 95% 0–88.9, vs. 52.6 m, CI 95% 16.7–88.5), but this difference was not statistically significant. The prognosis in AL is dominated by the heart involvement, which is massive in this series. In our Cox regression model, only three prognostic variables remain as independent prognostic factors: age, N-terminal pro-brain natriuretic peptide (≥8500 ng/L), and undergoing an autologous stem cell transplant, whereas left ventricular ejection fraction shows a marginal effect. More and large studies focusing on the AL/MM association are needed to uncover the characteristics and prognostic impact of this association.

The illuminated manuscripts at the Gulbenkian Museum were produced in the 17th century, in scriptoria of the Armenian diaspora. In this work, we selected analytical methods that can be used in situ to study the colors of the illuminations. Scientific analysis based on fiber-optics reflectance spectroscopy in the visible and Raman spectroscopy has shown the use of a medieval palette based on inorganic pigments such as lapis lazuli, minium, vermilion, orpiment, indigo, two different greens (vergaut and malachite), lead white and carbon black. More importantly, in this context, it showed that the very important reds and pinks are possibly based on carminic acid. The painting technique is, however, different, as are the ways of painting the faces, hands, and vestments. The range of colors in the Bible and the three Gospel Books, enhanced by lapis lazuli blue and organic reds and pinks, demonstrates a desire to create exceptional illuminated manuscripts.

Tuberculosis (TB) remains one of the leading infectious causes of death throughout the world. Extrapulmonary forms, namely adrenalitis and prostatitis, are rare presentations of TB and pose a difficult diagnostic challenge, given their non-specific manifestations. The authors present a case of a 42-year-old man with long-standing symptoms of fatigue, anorexia, weight loss, nightly fever and sudoresis. He also suffered from sporadic vomiting and episodic hypotension, and had skin hyperpigmentation, as well as frequent urination, perineal discomfort and pain at ejaculation. Laboratory investigation confirmed primary adrenal failure. On CT scan there were two hypodense right adrenal nodules and bilateral lung condensations with a tree-in-bud pattern. Another hypodense nodule was seen in the prostate. TB was diagnosed by isolating Mycobacterium tuberculosis following cultures of bronchoalveolar lavage, bronchial secretions, urine and ejaculate. Antibacillary treatment resolved the infectious lesions but the patient remained on corticosteroid replacement therapy for ongoing adrenal failure.

Synchrotron radiation X-ray fluorescence spectroscopy, in conjunction with atomic absorption and Raman spectroscopy, was used to analyze a set of top brand tattoo inks to investigate the presence of toxic elements and hazardous substances. The Cr, Cu, and Pb contents were found to be above the maximum allowed levels established by the Council of Europe through the resolution ResAP(2008)1 on requirements and criteria for the safety of tattoos and permanent makeup. Raman analysis has revealed the presence of a set of prohibited substances mentioned in ResAP(2008)1, among which are the pigments Blue 15, Green 7, and Violet 23. Other pigments that were identified in white, black, red, and yellow inks are the Pigment White 6, Carbon Black, Pigment Red 8, and a diazo yellow, respectively. The present results show the importance of regulating tattoo ink composition.

The heritage left by the Arab world in the history of science is directly related to the innovations in both the manufacturing of paper and the production of ink. Four Moroccan manuscripts dating to the eighteenth century, conserved at the royal library of Rabat, have been analyzed by X-ray diffraction (XRD), energy-dispersive X-ray fluorescence spectrometry (EDXRF), scanning electron microscopy coupled to energy dispersive X-ray spectroscopy (SEM–EDS), Raman and attenuated total reflection Fourier transformed infrared spectroscopy (FTIR-ATR). The combination of the Raman, EDS, and EDXRF spectroscopies results allows us to Characterized the inorganic inks, pigments and fillers used in paper making process. Iron-based ink was used for writing the text for all manuscripts. The main pigments used in the titles and in the illuminated part are found to be vermillion and red ochre in red samples, azurite with barium white and ultramarine in blue color, lead chromate in yellow color, copper and arsenic based ink in green color, carbon black for black color and gold. The main fillers identified in paper are calcite and kaolin. FTIR-ATR and Raman analysis revealed the presence of the characteristic bands of cellulose, the main component of paper. XRD confirms the presence of the fillers detected by FTIR-ATR. Finally, SEM allows to have a better knowledge of the typical morphology of the paper highlighting some effects of the degradation process. Graphic abstract